Enterovirus D68 And Some Old Reminders

Widespread news coverage over the last 24 hours has heightened concerns by many parents about a severe-symptom viral infection causing respiratory illness in children, predominately in the Midwest. Over the last month there has been a dramatic up-spike in children hospitalized with severe cold symptoms and wheezing. The virus isn’t new, but its effect on children seems to be. The Centers for Disease Control (CDC) has confirmed tests on children both in Kansas City and Chicago pinpointing the triggering virus as enterovirus D68. The biggest burden of illness has been in the Kansas City and Chicago areas where dozens of children were hospitalized daily, but there are reports of infections documented in about 10 additional states to date. The CDC report issued yesterday detailed data from their investigations

Of the tested and confirmed cases from Kansas City, their ages ranged from 6 weeks to 16 years, with a median of 4 years. Nearly 70 percent of patients had a previous history of asthma or wheezing. Of the Chicago group, ages ranged from 20 months to 15 years with a median of 5 years. Nearly three-quarters had a history of asthma or wheezing.

No question the illness has taken many by surprise as it’s an unusual time of year to see huge numbers of children with cold symptoms with severe wheezing. In areas where the infections started to pop up, schools been in session for a month or more so kids have been doing what they do best, playing in close contact and exchanging germs…

What Parents Need To Know:

Enteroviruses generally can cause a common upper respiratory infection often causing summertime “colds.” There are more than 100 different kinds of enteroviruses and although typically mild, rarely they can cause serious infections. Enteroviruses typically spread in fecal-oral fashion (from unwashed hands to mouth) but enterovirus D68 (EV-D68) is also spread from mucus and droplets in the air, basically when children and adults are in close contact. In general, children and adults can recover from enterovirus infections with rest and support, as their immune system fight the infection.

Asthma Is A Risk Factor for more severe symptoms with EV-D68. Children with underlying lung problems, particularly asthma, are at higher risk of needing support in the face of this infection. Over 1/2 of children with lab documented enterovirus D68 have also had asthma. The American Academy of Pediatrics advises, “children who have previously been diagnosed with asthma should follow their asthma action plans and communicate with their health care provider regarding yellow and red zone instructions.” Getting asthma under control during respiratory season is always a priority, however this infection serves a great reminder to check in with your child’s clinician and ensure you’re maximizing prevention efforts.

Enterovirus D68 (EV-D68) is spread through mucus, snot, and through viral particles in the air after infected people sneeze or cough. If a child wipes their nose while infected, for example, and then smears it on the table, those who touch those secretions can get the virus. There’s no vaccine to protect us from this virus and no current medications used to treat it so we support children while their bodies recover. This EV-D68 can cause more significant wheezing and respiratory complications, burdening children with difficulty breathing or challenges in keeping their oxygen levels up. No one has died from this infection thank goodness but about 15% of children hospitalized have been in the ICU.

Prevention of spread is most important if this virus continues to spread throughout the US. Washing hands with soap and water for 20 seconds prior to eating and after coughing/sneezing or after changing diapers, have children and adults stay home when ill, covering cough and sneezes, and clean surfaces regularly.

Enterovirus is not influenza so a quick reminder to get in soon for your family’s flu shots or flu nasal spray. Influenza is a different virus and can cause life-threatening or life-ending complications. The huge benefit is we have a vaccine to prevent it!

It’s always unnerving to hear of other children getting so sick; we can’t help but worry about the health of our families. We are fortunate, however, that the kids in the KC area that caught the virus have been well-treated by our local health providers and getting well.

Like so many other significant viral illnesses, EV-D68’s symptoms begin like a common cold. It’s hard to predict how ill your child may become when the symptoms start. For most kids, they will recover completely on their own. But, if you feel like your child is unusually sick or is having breathing difficulty; that’s when you need to call your doctor for some advice.

As we all think about the onslaught of coughs and colds this season we can be smart. Dr Burgert sums it up nicely, “My answers are always the same: Wash your hands. Prioritize sleep. Make healthy food choices. Get your flu shot when you can. And, please, stay home when you are sick.”

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